AB0296 RELATIONSHIP BETWEEN OBESITY AND ACUTE PHASE REACTANTS IN RHEUMATOID ARTHRITIS
Authors: A. N. Garza-Cisneros, I. J. Colunga-Pedraza, D. Á. Galarza-Delgado, J. R. Azpiri-López, A. B. Rodriguez-Romero, M. A. Balderas-Palacios, A. Garcia-Heredia, N. Guajardo-Jauregui, A. Cárdenas, D. E. Flores Alvarado
Journal: Annals of the Rheumatic Diseases (2022)

Background Obesity plays an important role in autoimmune and inflammatory diseases such as rheumatoid arthritis (RA). It has been demonstrated a paradoxical relationship between increased body mass index (BMI) and disease activity (1). Acute phase reactants (APR) play an essential role in determining the disease activity level (2). Objectives To compare APR levels in obese and non-obese patients with RA, and to establish their relationship with the disease activity level. Methods A total of 272 patients with a diagnosis of RA were included in a cross-sectional study. They were divided in two groups, 136 obese patients and 136 non-obese patients, matched by age, gender and comorbidities. The C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) level were measured, and the activity level was determined with Disease Activity Score 28-joint erythrocyte sedimentation rate (DAS28-ESR) and Disease Activity Score 28-joint C-reactive protein (DAS28-CRP). The distribution was evaluated with Kolmogorov-Smirnov. Comparisons with Chi- square test for qualitative variables, Student’s t-test, and Mann-Whitney U test for quantitative variables. Correlation between BMI and APR with Spearman-rho coefficient. Results The Spearman-rho coefficient showed a significant correlation between CRP level and BMI (rho=0.187, p=0 .002) (Figure 1). No difference was found between activity level when comparing both groups (Table 1). Table 1. Demographic Characteristics of the Patients Characteristics Obese RA Patients (n=136) Non-Obese RA Patients (n=136) P Value Age, mean ± SD 55.32±8.67 55.38±8.64 NS Female, n (%) 130 (95.5) 130 (95.5) NS BMI, mean ± SD 34.22±3.74 24.70±2.89 - T2DM, n (%) 30 (22.0) 23 (16.9) NS Hypertension, n (%) 62 (45.5) 48 (35.2) NS Dyslipidemia, n (%) 39 (28.6) 48 (35.2) NS Methotrexate, n (%) 119 (87.5) 114 (83.8) NS bDMARD, n (%) 7 (5.1) 11 (8.0) NS Glucocorticoid, n (%) 89 (65.4) 77 (56.6) NS CRP, median (p25-p75) 1.00 (0.58-1.73) 0.68 (0.38-1.25) NS ESR, median (p25-p75) 25.00 (16.00-36.00) 24.50 (14.25-37.75) NS DAS28ESR, mean ± SD 4.74±1.45 4.57±1.38 NS DAS28CRP, mean ± SD 3.62±1.46 3.37±1.39 NS RA, rheumatoid arthritis; NS, not significant; BMI, body mass index; T2DM, type 2 diabetes mellitus; bDMARD, biological disease-modifying anti-rheumatic drugs; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; DAS28, Disease Activity Score 28-joint. Figure 1. Correlation between BMI and CRP BMI, body mass index; CRP, C-reactive protein Conclusion Obese RA patients presented higher CRP levels compared to non-obese patients, suggesting that a higher BMI level may be related to a higher degree of inflammation and consequently worse systemic manifestations in patients. References [1]Summers GD, Metsios GS, Stavropoulos-Kalinoglou A, Kitas GD. Rheumatoid cachexia and cardiovascular disease. Nat Rev Rheumatol. 2010;6(8):445–51. [2]van Riel PLCM, Renskers L. The Disease Activity Score (DAS) and the Disease Activity Score using 28 joint counts (DAS28) in the management of rheumatoid arthritis. Clin Exp Rheumatol. 2016;34(4):40–4. Disclosure of Interests None declared